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International Urology and Nephrology

, Volume 47, Issue 3, pp 537–549 | Cite as

The effects of short-term vitamin D supplementation on glucose metabolism in dialysis patients: a systematic review and meta-analysis

  • Harini Sarathy
  • Vedatrayee Pramanik
  • Jared Kahn
  • Matthew K. Abramowitz
  • Kristen Meier
  • Preeti Kishore
  • Michal L. MelamedEmail author
Nephrology - Original Paper

Abstract

Purpose

We tested whether short-term vitamin D supplementation improves insulin resistance in patients with kidney disease, a condition with little intrinsic vitamin D activity.

Methods

PubMed, EMBASE and CENTRAL were searched for relevant observational studies and randomized clinical trials (RCTs). Random-effects models were employed for meta-analysis, and effect sizes were summarized as standardized mean difference (SMD) with 95 % confidence intervals. Separate analyses were done for RCTs and non-randomized intervention studies (NRIS).

Results

Seventeen studies (5 RCTs and 12 NRIS) were included. The meta-analysis population (n = 131) was mostly middle aged (40–50 years), male and non-diabetic, and on hemodialysis. The duration (4–12 weeks) and type of supplementation varied between studies. Among RCTs, compared to placebo, vitamin D supplementation was associated with significant decrease in fasting glucose [SMD −1.13, (−2.11 to −0.11)] and PTH levels [SMD −1.50, (−2.95 to −0.04)] but no difference in fasting insulin levels [SMD 1.32, (−0.15 to 2.79)]. Among NRIS, there was only a significant decrease in PTH levels [SMD −1.68, (−2.55 to −0.82)] between pre- and post-vitamin D treatment levels.

Conclusions

Short-term (4–12 weeks) supplementation with vitamin D is associated with lower fasting glucose levels in ESRD with no change in fasting insulin levels. However, the findings from this study are limited by the studies that were used in the meta-analysis, which were mostly small, used multiple different vitamin D compounds and dosing regimens, and had large heterogeneity, and funnel plots showed that there was a dearth of studies with null or negative finding. Therefore, larger RCTs need to be performed to answer this important clinical question.

Keywords

Dialysis Insulin resistance Meta-analysis Intervention studies Vitamin D 

Notes

Acknowledgments

Dr. Melamed and Dr. Abramowitz are supported by Grant DK 087783 from the National Institute of Diabetes, Digestive and Kidney Diseases and by Gottschalk Awards from the American Society of Nephrology (ASN Foundation for Kidney Research). Dr. Melamed was also supported by Grant DK 078774.

Conflict of interest

The results presented in this paper have not been published previously. None of the authors have any conflicts of interests to declare.

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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Harini Sarathy
    • 1
  • Vedatrayee Pramanik
    • 2
  • Jared Kahn
    • 3
  • Matthew K. Abramowitz
    • 2
    • 4
  • Kristen Meier
    • 2
  • Preeti Kishore
    • 2
  • Michal L. Melamed
    • 2
    • 4
    Email author
  1. 1.Department of Internal MedicineAlbert Einstein College of Medicine/Jacobi Medical CenterBronxUSA
  2. 2.Division of Nephrology, Department of Internal MedicineAlbert Einstein College of MedicineBronxUSA
  3. 3.Emory UniversityAtlantaUSA
  4. 4.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA

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